Endoscopic Cubital Tunnel Recurrence Rates

Abstract

Cubital tunnel syndrome is the second most common nerve entrapment in the upper extremity. There are no current publications concerning the recurrence rates after endoscopic cubital tunnel release. The purpose of this study is to evaluate the recurrence rate of endoscopic cubital tunnel release compared to published reports of recurrence following open cubital tunnel procedures. We reviewed 134 consecutive cases of endoscopic cubital tunnel release in 117 patients. There were 104 cases in 94 patients with greater than 3 months follow-up. The mean follow-up time was 736 days. They were grouped using Dellon's classification. Two literature control groups were used from published reports of recurrence rate following open cubital tunnel release. A recurrence was identified if the patient was symptom-free following surgery but had symptoms reappear 3 months or more after surgery as defined in the literature. Of the 104 cases, 92.31% had more than a 4-month follow-up. One case (0.96%) met the criteria for recurrence at 4 months postprocedure. Data were then compared to the literature control groups used from published reports of recurrence rates following open cubital tunnel release. Pooled, the combined controls had 22 of 180 cases (12.22%) with recurrences. The percentage of procedure recurrence varied significantly with p value equal to 0.0004. It is recognized that there is a lack of common classification and comparative analysis of these studies, but they do classify preoperative grading and recurrence similarly. We are 95% confident that our true recurrence rate is between 0.02% and 5.24% and that endoscopic cubital tunnel release has a recurrence rate, which is not higher than open cubital tunnel release literature controls.

Endoscopically assisted nerve decompression of rare nerve compression syndromes at the upper extremity

“…The technique presented here was adapted from one used previously for cubital tunnel syndrome. The latter was introduced in 1995 by Tsai et al [1] and since this princeps (principle) publication, two types of surgical endoscopically assisted nerve decompression techniques have been used: Knives [9][10][11][12] and scissors [13][14][15][16][17][18] techniques. Despite the excellent results sometimes reported in the literature, endoscopically assisted knife techniques are in our opinion hazardous because of the discrepancy between the size of the instruments and that of the nerve, and the inherent resulting potential for intraoperative nerve injuries.…”

Endoskopie in der Hand- und Ellenbogenchirurgie

“…Die Rezidivrate beträgt gemäß Cobb et al [6] zwischen 0,02 und 5,24 %. Somit ist sie nicht höher als die in der Literatur beschriebene Rezidivrate bei offenen Dekompressionsverfahren.…”

Nerve Compression: Ulnar Nerve of the Elbow

“…The technique offers a minimally invasive alternative to open surgical decompression. It has been suggested that the limited soft tissue dissection will result in shorter recovery time and less scarring [ 113 ]. Many variations exist, but most involve a small incision at the condylar groove [ 112 , 114 -117 ].…”

“…Cobb et al examined recurrence of symptoms following 134 consecutive cases of endoscopic cubital tunnel release [ 113 ]. The authors observed a recurrence rate between 0.02 and 5.24 %.…”